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Innovations in Suicide Prevention Research (INSPIRE)

自杀预防研究的创新（INSPIRE）

基本信息

批准号：
10449342
负责人：
Brian W Pence
金额：
$ 73.39万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-09 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10449342
关键词：
Address Adolescent Age Benchmarking Caring Cessation of life Clinic Clinical Data Data Linkages Data Set Databases Death Records Economics Emotional Epidemic Epidemiologic Methods Evaluation Future General Population Health Insurance Health Services Accessibility Health system Healthcare Healthcare Systems Hospitals Imprisonment Incidence Individual Inpatients Insurance Insurance Carriers Interruption Link Long-Term Care Machine Learning Medicaid Mental Health Services Methodology Monitor North Carolina Outcome Patients Pattern Persons Policies Population Positioning Attribute Prevention Prevention Measures Prevention Research Prisons Privatization Protocols documentation Provider Recording of previous events Records Registries Reporting Research Research Design Risk Risk Assessment Sampling Security Measures Suicide Suicide attempt Suicide prevention System Target Populations Time Time Series Analysis United States Update Violence Vulnerable Populations Work Youth base case control clinical predictors correctional system cost density design experience health care availability health care service utilization high risk innovation insurance claims mortality mortality risk patient population population based prevention evaluation preventive intervention prospective risk prediction study population suicidal morbidity suicidal risk suicide mortality tool years of life lost young adult

项目摘要

ABSTRACT Despite intensive prevention efforts from federal and state agencies, suicide is now the 10th leading cause of mortality overall in the US, increasing steadily over the past two decades and claiming more than 47,000 lives in 2017. The impact of suicide is particularly high among vulnerable populations such as adolescents and formerly incarcerated individuals. Suicide attempts also exact a high emotional, physical, and economic toll. Although much research has focused on causes and predictors of death from suicide, progress in suicide prevention has been hampered by data linkage and methodological challenges. While national mortality rates are known, entities with the potential to implement large suicide prevention initiatives – health systems, insurers, and departments of corrections – lack the linked data to monitor suicide incidence in their populations, establish benchmarks, and establish an evaluation framework for prevention efforts. Many individuals who die from suicide have had recent contact with a health care, health insurance, or correctional system, representing critical missed opportunities to implement suicide prevention measures. Two key needs are highlighted by the present RFA: linked surveillance systems that integrate healthcare, insurer (private and public), and correctional data with mortality outcomes to provide a framework for implementing and evaluating suicide prevention initiatives, and large and adequately powered datasets with rich health care access information over an extended period, matched with rigorous study designs for observational data. Therefore, our objective in the current proposal is to establish an in-depth suicide surveillance system linking multiple large, comprehensive databases and use that system to define suicide mortality benchmarks, identify predictors of suicide risk, generate risk prediction tools, evaluate suicide prevention efforts, and establish long-term workflow protocols to sustain the surveillance system. Our team is uniquely positioned to address these needs through our deep expertise in suicide, mental health, and health care utilization research; our extensive experience in application of rigorous epidemiological methods to large linked databases; our established access to comprehensive, regularly updated databases representing health care encounters, public and private insurance claims, corrections data, and suicide deaths in one of the most populous states in the US; and our successful work in prior projects to link all of these databases at the individual level using all appropriate safeguards and security measures. This project will be the first to link these large state- and healthcare system-level databases to establish an ongoing suicide surveillance system to identify short and long term predictors of suicide and to inform and evaluate suicide prevention efforts in North Carolina and across the United States. We anticipate such suicide prevention efforts will get embedded in healthcare systems where at-risk individuals can be identified and referred for prevention and care, thereby preventing suicides and reducing their societal impacts.

摘要